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ORIGINAL RESEARCH article

Front. Transplant.
Sec. Vascularized Composite Allotransplantation
Volume 3 - 2024 | doi: 10.3389/frtra.2024.1504959

Autologous porcine VRAM flap model for the optimization of VCA research

Provisionally accepted
Caitlin M. Blades Caitlin M. Blades 1Zari P. Dumanian Zari P. Dumanian 1Yong Wang Yong Wang 1Zhaohui Wang Zhaohui Wang 1Bing Li Bing Li 1Kia M Washington Kia M Washington 1Julia B. Slade Julia B. Slade 2Conor Evans Conor Evans 2Paula Arrowsmith Paula Arrowsmith 3Evan A. Farkash Evan A. Farkash 3Jason W. Yu Jason W. Yu 1Mark Greyson Mark Greyson 1Christene Ann Huang Christene Ann Huang 1Nalu Navarro-Alvarez Nalu Navarro-Alvarez 1*David W. Mathes David W. Mathes 1
  • 1 Department of Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, United States
  • 2 Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • 3 School of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States

The final, formatted version of the article will be published soon.

    As research advances in vascularized composite allotransplantation (VCA), large-animal models are essential for translational studies related to immune rejection and graft survival. However, procurement of large flaps can cause significant defects, complicating wound closure and increasing postoperative risks. This study details the surgical techniques and outcomes of autologous vertical rectus abdominis myocutaneous (VRAM) flap transplantation and neck flap isolation with induced ischemia in a swine model. The purpose of this study was to identify the most effective control procedure for use in future VRAM flap allotransplantation research. We performed two left heterotopic autologous VRAM flap transplants and two right anterolateral neck flap isolations using female Yucatan pigs. Postoperatively, animals were monitored for complications and flap healing, with punch biopsies taken on POD1, 5, and at the end of the study for histological analysis. Transcutaneous oxygen and temperature were also recorded. Both autologous flaps survived after vessel anastomosis, with effective closure of abdominal defects using suturable mesh, and no postoperative complications were observed. Histology revealed mild dermal edema and perivascular inflammation on POD5. In the neck flap group, both flaps survived temporary ischemia, however, postoperative complications included dorsal flap necrosis and wound dehiscence, requiring reoperation. No gross inflammation or edema was observed following surgery and histologically there was only mild dermal edema on POD5. In conclusion, we have developed a low-risk, technically feasible porcine autologous VRAM flap transplantation model and our findings support its use in future VCA studies.

    Keywords: Vertical rectus abdominis myocutaneous flap, autologous, Swine, Ischemia, neck flap

    Received: 01 Oct 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Blades, Dumanian, Wang, Wang, Li, Washington, Slade, Evans, Arrowsmith, Farkash, Yu, Greyson, Huang, Navarro-Alvarez and Mathes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nalu Navarro-Alvarez, Department of Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.